In the Community
The importance of partnerships and networking to reduce health disparities was emphasized April 7 at the Community Campus Partnership Conference to address health disparities held at the Four Points by Sheraton in Little Rock. The conference, presented by the University of Arkansas for Medical Sciences (UAMS), brought together over 200 faith and community leaders, educators, health care providers and researchers to discuss health equity in Arkansas.
“This is an opportunity for us, as researchers, to explain to community leaders what community-based participatory research is, as well as an opportunity to share the research we’ve been working on with the faith community and what we have found along the way,” said Keneshia Bryant-Moore, Ph.D., R.N., associate professor in the UAMS College of Public Health’s Health Behavior and Health Education Department and conference planning committee chairperson. Attendees are able to utilize the conference to identify potential partners, as well as tie already existing community programs to ongoing research.
Keynote speaker Joshua Dubois, former White House director of faith-based and neighborhood partnerships under President Barak Obama, discussed how effective it is for people in health care to partner with hospitals, the community and other leaders to reduce health disparities. Dubois offered the “Memphis Model,” as an example of a community working together for health equity. The model shows that by engaging faith-based communities in partnerships, health care providers can build relationships with communities and determine how to reduce those existing health disparities.
The morning session featured Wana Bing, project manager for the UAMS Office of Community Health and Research; Nia Aitaoto, Ph.D., co-director of the UAMS Center for Pacific Islander Health; and Sheldon Ricklon, M.D., associate professor in the UAMS College of Medicine Department of Family and Preventive Medicine. Northwest Arkansas is home to the largest population of Marshall Islanders outside of the country itself. The panel gave an overview of the history of this population coming to Arkansas and discussed the importance of the Marshallese community engaging in research.
The Marshallese in northwest Arkansas have high rates of diabetes and other chronic diseases, as well as disparities such as access to health care and healthy food options. This makes it even more important for them to engage with researchers so these disparities can be addressed.
The afternoon closed with breakout sessions on six main topics: service learning, brainstorming on addressing health issues in the community, community-based participatory research training, faith and government collaborations for health equity, mental health in faith communities, and best practices to engage faith communities.
The conference was supported by grants from the Patient-Centered Outcomes Research Institute (PCORI) Eugene Washington PCORI Engagement Award, the Health Resources and Services Administration (HRSA) Nursing Workforce Diversity grant, the UAMS Translational Research Institute, and the Arkansas Minority Health Commission. It was held in collaboration with the Arkansas Foundation for Medical Care, the Arkansas Department of Health and Baptist Health Physician Partners.
Pest control and chemical use in the home are not topics that get much play in K-12 science. Applied science is not a priority for Arkansas teachers, who are charged with imparting the fundamentals of the physical and biological sciences. But, to Alesia Ferguson, Ph.D., MPH, Associate Professor in the Department of Environmental and Occupational Health at the UAMS Fay W. Boozman College of Public Health, these subjects are central to science literacy of all citizens and making wise choices for a healthy home environment. And, if taught in an engaging way, these topics can excite students about science, hone their critical thinking skills and serve as a platform for science fair projects – all of which help to promote and encourage more young scientists.
Three years ago, Ferguson, a Stanford-trained environmental engineer, made her case to the Environmental Protection Agency (EPA), and the agency agreed, awarding her $215,000 to support a two-year teacher education program in Arkansas on integrated pest management and chemical use reduction in the home. Integrated pest management is a holistic approach that advocates use of toxic pesticides only as a last resort.
In addition, teachers could train on innovative teaching strategies called Liberating Structures to enable them and their students to break out of stultifying classroom methods – I lecture, you memorize for a test – for deeper, more active learning. The program also included learning forums for parents and community members.
Dr. Ferguson and her team of graduate students created a robust package of online instructional materials that includes a 10-day Pest Management Chemical Reduction (PMCR) curriculum for middle and high school, teacher training materials, slides and videos and website links. It is all available for free and is also in Spanish. It is suitable for classroom and homeschool educators, students, parents, and the general public.
The curriculum exposes students to some chemistry basics, the routes in the body to chemical exposure, principles of a healthy and safe home, and the differences in health risk of particular pests and household chemicals. Classroom activities include small group projects and problem-solving, and interactive online learning, discussion and debate, video and art. There’s a hands-on lesson on making laundry detergent out of safe, common ingredients.
Dr. Ferguson reached out to colleagues at two of Arkansas’ 11 STEM Centers to help with teacher recruitment. The Centers affiliated with the University of Arkansas at Little Rock (UALR) and University of Arkansas at Pine Bluff (UAPB) promoted the program to eight school districts that serve communities that are diverse in terms of race/ethnicity and income.
Children’s health and environmental exposures to harmful chemicals have long been research interests of Dr. Ferguson, which she has coupled with a passion for community education. Her past EPA-supported educational outreach programs have focused on prevention of health hazards associated with lead, radon, carbon monoxide, mold and asthma allergies in the home. She is not against chemicals and pesticides, she explains, just unwise use.
“I am not advocating no pesticides or chemicals,” Dr. Ferguson said. “It’s chemical use reduction we need to think about. We use so many. Kids have no concept that the chemicals around them can be harmful. It is important to promote safety about all of these products around the home – their use, storage and safer choices. These concepts have never been taught in the schools.”
The grant paid for teaching kits and stipends to 75 participating teachers from 45 schools in more than 20 cities and towns. It also paid for students’ science fair materials and entry fees, as well as stipends for 15 graduate students from UAMS, the Clinton School of Public Service and UALR. They provided teacher support and served as mentors to science fair aspirants. It also supported public forums, through which several hundred community members learned about PMCR concepts.
The original grant proposed allowed for one class per teacher to take part, but teachers teach multiple classes, and many wanted all their students involved. Unable to say no, Dr. Ferguson broadened the opportunity. In the end, more than a thousand students were exposed PMCR concepts, about 300 entered science fairs, and many won awards. Some were also winners at regional fairs. For some teachers and schools, it was their first time putting on a science fair or taking part in one.
Clarksville High School teacher Melisa Jennings is not new to science fairs, but she found Dr. Ferguson’s training and guidance valuable, especially in regard to helping students come up with project ideas that are “pertinent to today’s societies and cultures” and “not ‘too elementary.’”
“Dr. Ferguson gave me the inspiration to continue to push my students to perform as actual scientists and challenge them to find the answers to their experimental questions,” Ms. Jennings said. “I am continuing the science fair again this year, and my teaching strategies have changed dramatically this year due to what I learned through the program last year. I believe my students’ projects are going to be exceptionally better than years previous.”
Although the project has ended, it lives on through the many individuals impacted – teachers and students, as well as parents, whose children came home eager to share what they had learned about particularly toxic chemicals and safer alternatives. With that knowledge, many changed how they dealt with household pests or what cleaning, health and beauty, and home maintenance products they used.
“Several people contacted me to say that they no longer have to use a pest control company,” Dr. Ferguson said.
Pest Management Chemical Reduction (PMCR) curriculum
Community groups that partner with the University of Arkansas for Medical Sciences (UAMS) Translational Research Institute (TRI) were honored at the TRI’s 3rd Annual Community Partner Celebration on Nov. 13 at The Centre at University Park in Little Rock.
Fourteen of the groups honored are community partners of the Office of Community-based Public Health (OCBPH) at the UAMS Fay W. Boozman College of Public Health (COPH). A brief description of each organization’s work and the nature of their collaboration with the College are below.
Arkansas Community Health Worker Association (ARCHWA) is a nonprofit, statewide membership organization led and directed by community health workers (CHW). ARCHWA supports CHWs to obtain additional training and continuing education, provide networking opportunities, and facilitates CHWs and CHW programs to collaborate with each other and with community-based, government, and health and educational agencies and institutions. Its members also promote CHWs by increasing awareness of their role in improving health and quality of life while reducing the cost of healthcare. The COPH is a founding partner and key supporting organization along with UAMS Northwest Arkansas Campus, the Arkansas Department of Health, Tri-County Rural Health Network, the Arkansas Center for Health Improvement, and the Arkansas Foundation for Medical Care.
Arkansas Voices for the Children Left Behind is a statewide, not-for-profit organization whose mission is to advocate for children left behind by incarceration or loss of a parent for any reason and to provide mentoring, services and supports for the children, their caregivers, and incarcerated parents, with the goal of strengthening and empowering the family unit. Arkansas Voices has been a longtime partner of the COPH and is helping the College integrate topics related to incarceration and criminal justice into public health curricula. The organization is also supporting the implementation of the UAMS Little Rock Transitions Clinic program, a Primary Care-Public Health Partnership serving former prisoners.
Divine Deliverance, First Baptist Dew Drop Church, New Light MBC, Pleasant View Ministries Church and Regenerated, MB are faith leaders in Jefferson and Phillips counties. They have led the promotion of emotional health in their congregations and wider communities in the REJOICE (Renewed and Empowered for the Journey to Overcome in Christ Everyday) program. REJOICE is an evidence-based depression intervention for African-American adults of faith that includes lay-led small groups that meet on a regular basis and community-wide events. REJOICE is funded by the National Institute on Minority Health and Health Disparities and includes collaborators from the TRI, the UAMS colleges of Public Health, Nursing and Medicine, the Arkansas Center for Health Disparities, the Arkansas Prevention Research Center, the Mid-Delta Community Consortium, 10,000 Black Men, the Boys Girls and Adults Community Development Center, and Tri-County Rural Health Network.
El Zocalo Immigrant Resource Center serves Central Arkansas’s growing immigrant population by providing culturally appropriate programs and supports such as English and adult education classes, a clothing and food pantry, and referrals to services. El Zocalo has also led and participated in activities that support research by UAMS, such as hosting a community review board focused on the health of Latina women; leading recruiting, and participating in COPH forums in the community; and producing a community resource guide.
House of Benjamin, founded by Mr. Benjamin Hood, significantly impacts the lives of many people in the 12th Street community in Little Rock through its work, which includes rehabbing homes for persons needing long-term care and providing employment and counseling for persons in recovery from addiction. Mr. Hood and his volunteers have hosted COPH faculty, staff and students at events in the 12th Street neighborhood, including for MLK Day of Service events at the Promise Garden Park at 12th and Peyton streets. They have also participated in community forums and planning sessions held by the COPH’s Center for Health Disparities Community Engagement Core to identify residents’ health priorities.
Human Rights Campaign’s (HRC) Arkansas office has played a leadership role in advocacy for improving health and healthcare disparities among lesbian, gay, bisexual, and transgender individuals in Arkansas. The HRC, UAMS and Arkansas Children’s Hospital hosted a conference in 2014 on LGBT health disparities and health care.
Oak Forest United Methodist Church – Reverend Mike Blanchard of Oak Forest United Methodist Church serves on the community advisory board of the Arkansas Center for Health Disparities Community Engagement Core. Rev. Blanchard also serves on the Community Steering Committee of the Central Arkansas Mobile Market, an initiative to increase access to healthy food in Central Little Rock. His church operates Shepherd’s Hope Neighborhood Health Center, a Christian medical, dental and health education ministry that provides these services to uninsured and under-insured Little Rock residents free of charge.
The church and its clinic have been partners of the COPH since 2013. Shepherd’s Hope has hosted COPH AmeriCorps VISTAs and Community Connectors to help with clinic flow and patient follow-up. Rev. Blanchard has been an active supporter of TRI activities including the Sentinel Network Community Health Needs Assessment, for which COPH students administered surveys at the church’s food pantry.
Seeds of Liberation, Inc. is a non-profit organization that works alongside Arkansas’ marginalized communities to create a just, equitable and empowering criminal justice system. The organization has supported the development of the Little Rock Transitions Clinic, a new program based at the UAMS Family Medical Center that addresses former prisoners’ critical medical and social needs. COPH faculty and staff participated in the development of the clinic program.
TransForm Health Arkansas Research Working Group, which is committed to improving the health and health care of Arkansas’ transgender population, was formed by COPH researchers and others at UAMS and in the community. Its purpose is to advise and guide the work of the Transform Health Arkansas project. The project engages with the transgender and gender non-conforming community to learn about their most pressing health and health care issues and what they want researchers to study. The groups meets monthly with the project team to advise on decisions about research promotional materials, survey instruments, outreach, and many other aspects of the project.
The Young Adult Opportunity Center (YAOC) is an anchor in midtown Little Rock and is providing invaluable services to youth and young adults in the area. The COPH has a long-term commitment to this community and is proud to work with the YAOC. The YAOC provides assistance to young people seeking employment or other services. As a positive presence in its community, the YAOC directly impacts social determinants of health and the community’s overall well-being. The College has partnered with the YAOC in various ways, mainly through activities of the Promise Garden Park, which is located on the grounds of the YAOC. COPH faculty, students and staff have volunteered at the park for workdays, MLK Days of Service, and joint initiatives with other organizations that benefit the neighborhood.
Larry Braden, M.D., started practicing medicine in the south Arkansas town of Camden in the early 1980s, soon after completing his residency at the University of Arkansas for Medical Sciences (UAMS). Camden was then a thriving community whose economy was supported by industry. But then key industries left, and by 2014 the county Camden is in was ranked last among Arkansas’ 75 counties for health outcomes and quality of life by County Health Rankings for the United States.
That news jolted Dr. Braden, who rallied other Camden citizens to action. They have resolved to bring their town back. Leaders at the UAMS Fay W. Boozman College of Public Health (COPH) also want to be involved in that effort. Preliminary discussions have centered on possible ways that faculty and doctoral students could lend their expertise; those interested are encouraged to contact COPH Dean James Raczynski, Ph.D..
Dr. Braden is the President of the Arkansas Board of Health and a family physician at the Ouachita Valley Family Clinic. In a presentation on Oct. 29 at Arkansas Department of Health Grand Rounds, “Is There Any Hope – A Community Response to Health Rankings,” Dr. Braden told the story of Camden’s decline and what the community is doing about it.
“The health rankings are much more than health statistics,” he noted. “They are a measure of human suffering that can be found in every one of our communities.”
In the early 1980s, Camden’s downtown had two department stores, a hardware store and a coffee shop that was a popular early morning gathering place.
“It seemed like a very vital, alive, cohesive community,” Dr. Braden recalled. “Now the downtown is in disrepair, and once beautiful homes are unkempt.”
By the late 1980s, several industries had closed their Camden facilities. The percentage of residents living in poverty in Ouachita County, where Camden is located, was 18 percent. By 2013, that had risen to 26 percent.
“A mobile middle class left our community, and the poor were left behind,” Dr. Braden said. “Poverty is the reason why we have more problems than other communities. The County Health Rankings correlate very well to our experience. We are at the bottom of the heap in regard to health behaviors and economic factors” – the primary drivers of health outcomes according to the ranking system.
Poverty has accentuated divisions of class and race in Camden. Even in a town as small as Camden, whose estimated 2014 population was 11,569, income inequality has frayed the social cohesion of the community, consistent with local and national patterns across the globe, as measured by the Gini coefficient, a measure of the degree of inequality in the distribution of family income across a geographic area.
“With a rise in the Gini Co-efficient there is a decrease in trust,” Dr. Braden said. “The affluent don’t spend time with the poor and don’t know them or understand them. They come to not trust them. That is what is going on in a lot of our communities.”
When a well-to-do Camden resident complained to Dr. Braden about long wait times to see a doctor, he observed, “Build me a community to attract doctors and nurse practitioners and they will come.”
During past 15 months, Camden leaders and regular folks have come together to lay the groundwork for creating a community environment that fosters health. In October the newly formed HOPE coalition – the acronym stands for health outcomes, positive effects – met for the first time. On the drawing board are plans for walking and bike trails, sidewalks, access to fresh and affordable foods, better transportation, renovating an old school gym to be a community center, and a centralized connecting point (“The Hub”) where citizens can access needed services.
“In all these things, Camden has awakened and is getting some things done,” Dr. Braden said. “Apathy and old ways of complaint without solutions have become unacceptable.”
Real change will take more than creation of tangibles such as community gardens and sidewalks, it will take changes in relationships, understanding and attitudes, noted Dr. Braden, who is also an Episcopal priest for a small parish in Camden.
Barriers will need to come down and trust built. Bringing blacks and whites together is the aim of a new venture, Unity in the Community.
“Blacks and whites have pulled together in common activities so that we can love and know each other more,” Dr. Braden said.
The serious public health problems affecting Camden and the health of its citizens will require new understanding about people who are poor and why violence, criminal behavior, poor health choices, teen pregnancy, and dropping out of high school are more common among them.
“The poor are acting in very predictable and consistent ways; the higher the income inequality, the worst behaviors and poorer health,” Dr. Braden said. “We have got to stop sitting around the table and condemning the behavior of the poor. We have got to identify the poor and give them a pathway out of poverty. We have not valued them as individuals and what they might bring to the community. We need to find a way to refranchise the poor.”
Dr. Braden knows that much work lies ahead if Camden’s quality of life and health outcomes are to improve. There have been 15 months of preliminary discussion and planning. In the next phase, the HOPE coalition will develop a set of recommendations for government leaders and citizens. No target date has been set for that to be completed.
“We are getting people talking, and something good will come of it,” Dr. Braden said.
A golf tournament will be held on April 25 at the Country Club of Arkansas to raise funds for the 12th Street Health and Wellness Center, an inter-professional free clinic established by UAMS to provide health and wellness services and health education for residents of the 12th Street neighborhood and surrounding areas. Entry deadline is April 18.
On the day of the event, the provided lunch starts at noon, and the tournament starts at 1 pm. The cost per team is $400. The format is 4-person scramble. Sponsorship opportunities are also available starting at $200.
All net proceeds from the event will benefit the Center, where services are provided by students from the UAMS Colleges of Health Professions, Medicine, Nursing, Pharmacy, Public Health and the Graduate School under the supervision of licensed health care professionals.
For more information, contact event organizer, Stewart Clark, at (501) 548-1918 or SCLARK@uams.edu. Mr. Clark is a second-year student in the COPH’s Master in Health Administration degree program and serves on the board of the 12th Street Health and Wellness Center.
On Jan. 19, the Office of Community-Based Public Health (OCBPH) at the UAMS Fay W. Boozman College of Public Health partnered with Neighbors that Love (NTL) community group in their Second Annual Day of Service to honor Martin Luther King, Jr. About 120 volunteers gathered that morning at the Bishop Leodies and Goldie Warren Family Life Center on 12th Street in the heart of Little Rock and spent the day working on beautification and gardening projects for the surrounding neighborhood.
Neighbors that Love co-founder Anika Whitfield, DMP, welcomed the volunteers with remarks about Dr. King’s legacy of service and lifetime commitment to racial equality and social justice. Participants divided into work groups and received their assignments for the day: raking leaves, preparing a composting lot, building portable garden boxes, readying the Promise Garden Park at the corner of 12th and Peyton streets for spring crops, and clearing debris from a vacant lot.
Close to 40 volunteers spread out along West 13th, Peyton and Washington streets, raking leaves and picking up trash. Nearly 200 bags of leaves were collected from the homes of residents, alleyways and empty lots. The leaves were deposited to an empty lot that NTL recently acquired from the city and plans to turn into a large space for composting.
Another group of volunteers filled more than 20 wooden boxes with soil and transferred cabbages, collards and turnip greens from the garden into them. The boxes are being delivered to area residents who had expressed an interest in having one. The group also cleared and added compost to garden beds at the garden park in preparation for spring planting.
Another group cleared debris from a lot where an old building had recently been demolished. The lot, owned by a NTL member, will be transformed into a space to promote community gatherings around healthy food, recreation and green space.
Volunteers enjoyed a late lunch of barbeque and pizza to end the work day.
The Promise Garden was established last year by NTL and is its primary project. In its first growing season it produced large yields of sweet potatoes, peas, beans, kale, turnip greens, cilantro, watermelons, cantaloupes and other crops, which were distributed to neighbors.
Besides the COPH OCBPH, other collaborating organizations and volunteers included Bishop Leodies and Goldie Warren Family Life Center, Great Christ Temple Church, the Young Adult Opportunity Center, Arkansas Commitment, the O.K. Program, the Korean Disciple Church of Arkansas, Mosaic Templars, Centennial Bank, and many neighbors and individuals.
Neighbors that Love is a community-based organization founded in 2013 from a desire to build on already existing community assets in the 12th Street area and to actively contribute to the ongoing revitalization efforts there. Neighbors that Love manages the Promise Garden Park and the 12th and Oak Community Garden in addition to hosting monthly Days of Neighborly Love. For more information about NTL, email NeighborsThatLove@gmail.com.
More than fifty people gathered at the Willie Hinton Neighborhood Resource Center on Oct. 28 to learn about opportunities for community-academic research partnerships, network, and be inspired by others who are working hard to create and maintain healthy communities. This gathering, the Community-Academic Partnerships Mini Conference, was hosted by the Office of Community-Based Public Health (OCBPH) at the Fay W. Boozman College of Public Health (COPH) in collaboration with Tri County Rural Health Network, a long-standing community partner of the OCBPH.
The conference was put on to facilitate introductions and serve as a mixer between community-based organizations and staff and faculty from the COPH. Community organizations that serve Central Arkansas and whose work broadly relates to health or healthcare were invited to attend. Jimmy Parks, DrPH, a Community Connector with Tri County Rural Health Network, visited with many organizations prior to the conference to learn about their work and tell them about the types of research and service learning opportunities with the COPH. Ashley Bachelder, MPS, MPH, OCBPH Community Program Manager, met with COPH faculty prior to the meeting to learn about their current research focus and to brainstorm about ways to involve the community.
Representatives from 27 community organizations attended, including the Central Arkansas Re-Entry Coalition, Helping Hand of Greater Little Rock, the Arkansas Hunger Relief Alliance and the Center for Women in Transition. Also in attendance were more than 20 UAMS COPH faculty and staff from the departments of Health Behavior and Health Education (HBHE), Epidemiology, Healthy Policy and Management and Environmental and Occupational Health, as well as the Master of Health Administration program. A few students and staff from the new UAMS Center for Health Literacy and the Translational Research Institute also attended.
The conference opened with welcoming remarks from COPH Dean Jim Raczynski, Ph.D. and participant introductions. The group then moved into an interactive activity in which attendees shared about what motivates them to do the work they do. OCBPH Director Kate Stewart, M.D., MPH spoke briefly about research basics and the ways that community organizations and individuals can be involved in research, which include serving on a community advisory board or as a research study co-investigator.
A panel followed in which individuals involved in ongoing academic-community partnerships spoke about their work and experiences: MPH student Jake Coffey, MPS, and COPH HBHE Associate Professor Nick Zaller, Ph.D., speaking about their work on prison re-entry with their partners from Arkansas Voices and the Central Arkansas Re-Entry Coalition; Dr. Stewart and partners from Tri County Rural Health Network, speaking about their work on access to healthcare in the Delta; and COPH HBHE Assistant Professor Tiffany Haynes, Ph.D. and Tri County Rural Health Network, speaking about their project on depression in Jefferson County. The conference ended with a networking activity.
Conference organizers declared the event a great success, so much that the OCBPH is considering making it a semi-annual event to occur every semester.
“We were highly encouraged by the great turn-out,” Dr. Stewart said. “It is great to see so many of our faculty members wanting to engage with the community, and so many community organizations wanting to learn more about potential partnerships with us. We also learned that the community organizations appreciated the time and space to network with each other, in addition to just UAMS, so we are happy to help convene the space for that.”
For more information about the OCBPH, contact Ashley Bachelder at AEBachelder@uams.edu or 501-526-6632.